Summary
Four examples of an endoscopically detected oesophageal melanotic lesion were examined by light microscopy, light microscope histochemistry and transmission electron microscopy, and were compared with 13 control samples of normal oesophageal epithelium. By light microscopy, pigmented melanocytes lacking atypia and mitoses were observed amongst the keratinocytes in the basal layer of the oesophageal mucosa. Junctional activity was absent. The mechanism of pigmentation was studied and found to consist of: an increase in the number of melanocytes in the basal layer of the mucosa, an increase in the quantity of melanin in these melanocytes, transfer of melanin from melanocytes to keratinocytes and to macrophages and fibroblasts in the tunica propria. Since all the lesions demonstrated increased numbers of both melanocytes and melanosomes, the term oesophagealmelanocytosis rather thanmelanosis is suggested, to emphasise the essential character of the lesion as a cellular proliferation. The value of sampling these pigmented lesions during endoscopy is emphasised as a means of obtaining well-preserved material for the evaluation of a lesion which some authorities have viewed as a possible precursor for oesophageal malignant melanoma.
Similar content being viewed by others
References
Anton-Lamprecht I, Tilgen W (1972) Zur Ultrastruktur der melanotischen Pracancerose. Arch Dermatol Forsch 244:264–269
Anton-Lamprecht I, Schnyder UW, Tilgen W (1971) Das “Stade ephelide” der melanotischen Pracancerose. Eine vergleichende klinisch-histopathologisch-elektronenmikroskopische Studie. Arch Dermatol Forsch 240:61–78
Bisordi WM, Kleinman MS (1976) Melanosis duodeni. Gastrointest Endosc 23:37–38
Chalkiadakis C, Wihlm JM, Morand G, Weill-Bousson M, Witz JP (1985) Primary malignant melanoma of the esophagus. Ann Thorac Surg 39:472–477
Dumas O, Barthelemy C, Billard F, Dumollard JM, Boucheron S, Calmard P, Rousset H, Audigier JC (1990) Isolated melanosis of the esophagus: systematic endoscopic diagnosis. Endoscopy 22:94–95
Fitzpatrick TB, Breathnach AS (1963) Das epidermale Melanin-Einheit-System. Dermatol Wochenschr 147:481–489
Ghadially FN, Parry EW (1966) An electron-microscope and histochemical study of melanosis coli. J Pathol Bacteriol 92:313–317
Guzman RP, Wightman R, Ravinsky E, Unruh HW (1989) Primary malignant melanoma of the esophagus with diffuse melanocytic atypia and melanoma in situ. Am J Clin Pathol 92:802–804
Kanavaros P, Galian A, Periac P, Dyan S, Licht H, Lavergne A (1989) Melanome malin primitif de l'oesophage developpe sur une melanose. Etude histologique, immunohistochemique et ultrastructurale d'un cas. Ann Pathol 9:57–61
Kimball MW (1978) Pseudomelanosis of the esophagus. Gastrointest Endosc 24:121–122
Kreuser E-D (1979) Primary malignant melanoma of the esophagus. Virchows Arch [A] 385:49–59
MacKie RM (1984) Milne's dermatopathology. Arnold, London, pp 288–289
Makuuchi H, Mitomi T (1986) Esophageal melanosis (in Japanese). Dig Med 4:492–499
McGregor BC, McGregor JL, Weiss LM, Wood GS, Hu C-H, Boukerche H, Warnke RA (1989) Presence of cytoadhesins (IIb-IIIa-like glycoproteins) on human metastatic melanomas but not on benign melanocytes. Am J Clin Pathol 92:495–499
Mesara BW, Barton WD (1968) Primary malignant melanoma of the upper respiratory tract. Cancer 21:217–225
Ohashi K, Kato Y, Kanno J, Kasuga T (1990) Melanocytes and melanosis of the oesophagus in Japanese subjects — analysis of factors effecting their increase. Virchows Arch [A] 417:137–143
Ohgami M, Kumagai Y, Makuuchi H, Miyoshi H, Yamazaki E, Suyama K (1984) Esophageal melanosis (in Japanese). Prog Dig Endosc 25:60–62
Ohmori T, Makuuchi H, Kumagai Y, Yamazaki K (1990) Esophageal melanosis (in Japanese). Endosc Dig 2:1158–1159
Pava S de la, Nigogosyan G, Pickren JW, Gabrera A (1963) Melanosis of the esophagus. Cancer 16:48–50
Piccone VA, Klopstock R, LeVeen HH, Sika J (1970) Primary malignant melanoma of the esophagus associated with melanosis of the entire esophagus. J Thorac Cardiovasc Surg 59:864–870
Rhodes AR, Seki Y, Fitzpatrick TB, Stern RS (1988) Melanosomal alterations in dysplastic melanocytic nevi. Cancer 61:358–369
Sharp JR, Insalaco SJ, Johnson LF (1980) “Melanosis” of the duodenum associated with a gastric ulcer and folic acid deficiency. Gastroenterology 78:366–369
Shibata T (1973) Distribution of human melanocytes in the stratified squamous epithelium of mucosa (in Japanese). Ochanomizu Med J 21:87–96
Sun J, Morton TH, Gown AM (1990) Antibody HMB-45 identifies the cells of blue nevi. An immunohistochemical study on paraffin sections. Am J Surg Pathol 14:748–751
Tateishi R, Taniguchi H, Wada A, Horai T, Taniguchi K (1974) Argyrophil cells and melanocytes in esophageal mucosa. Arch Pathol 98:87–89
Trodahl JN, Sprague WG (1970) Benign and malignant melanocytic lesions of the oral mucosa. Cancer 25:812–823
Wanebo HJ, Woodruff JM, Farr GH, Quan SH (1981) Anorectal melanoma. Cancer 47:1891–1900
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yamazaki, K., Ohmori, T., Kumagai, Y. et al. Ultrastructure of oesophageal melanocytosis. Vichows Archiv A Pathol Anat 418, 515–522 (1991). https://doi.org/10.1007/BF01606502
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01606502